Linking Mother–Child Discrepancies to Behavioral Observations of Children’s Anxiety

Background

Informant discrepancies between mother and child have challenged the assessment, classification, and treatment of childhood anxiety. Despite numerous studies on this matter, the implications and consequences for research and clinical practice remain unclear.

Objective

The present study aimed to obtain meaningful clinical information about informant discrepancies by examining mother–child agreement for anxiety subtypes, and by exploring mother–child discrepancies in relation to independent observer ratings of behavioral anxiety.

Method

The screen for child anxiety related emotional disorders was administered to 79 mothers and clinically referred anxious children aged 7–13 years. Mother–child dyads were observed during an anxiety-provoking task and independent observers rated children’s observed anxiety.

Results

The findings indicated a high level of mother–child disagreement on reports of anxiety. There was variability in levels of agreement between subtypes of anxiety, with significantly stronger mother–child agreement for separation compared to other forms of anxiety. Observed proximity between the mother and child was positively associated with child-reported separation anxiety and children’s observed anxious voice was negatively associated with child-reported panic disorder.

Conclusions

The results highlight the need to incorporate a multi-informant assessment of childhood anxiety in clinical practice and research, in particular for subtypes of anxiety problems that are characterized by less observable and more internally experienced components.

     

Three-year clinical effectiveness of a two-step self-etch adhesive in cervical lesions

A 3-yr randomized, controlled prospective study evaluated the clinical effectiveness of a mild two-step self-etch adhesive, Clearfil SE, in Class-V non-carious lesions. The hypothesis tested was that prior selective etching of enamel with phosphoric acid does not affect the 3-yr clinical performance of this adhesive. A total of 100 lesions in 29 patients were randomly restored in one or two pairs, according to two experimental protocols: (i) application of Clearfil SE according to the instructions of the manufacturer (C-SE non-etch); and (ii) similar application of Clearfil SE with prior etching of enamel cavity margins with phosphoric acid (C-SE etch). Clearfil AP-X was used as a restorative material. At 3 yr, 90% of the restorations were examined for retention, marginal integrity, marginal discoloration, caries recurrence, postoperative sensitivity, and preservation of tooth vitality. An excellent retention rate (100%) was noted after 3 yr of clinical functioning. Only one restoration of the C-SE etch group was clinically unacceptable owing to the presence of a severe cervical marginal defect. A pairwise comparison between both groups showed a significant difference only in the number of small marginal defects at the enamel side, which was higher in the C-SE non-etch group. These incisal defects were small and clinically irrelevant. Superficial marginal discoloration increased slightly in the C-SE non-etch group and was related to the higher frequency of small incisal marginal defects. In this latter group, localized marginal discoloration was observed significantly more in smokers. In conclusion, the clinical performance of the mild two-step self-etch adhesive, Clearfil SE, remained excellent after 3 yr of clinical functioning. Additional etching of the enamel cavity margins was not critical for its clinical performance.     

Differential effects of testosterone on neuronal populations and their connections in a sensorimotor brain nucleus controlling song production in songbirds: a manganese enhanced-magnetic resonance imaging study

Nucleus HVC (formerly called high vocal center) of songbirds contains two types of projecting neurons connecting HVC respectively to the nucleus robustus archistriatalis, RA, or to area X. These two neuron classes exhibit multiple neurochemical differences and are differentially replaced by new neurons during adult life: high rates of neuronal replacement are observed in RA-projecting neurons only. The activity of these two types of neurons may also be modulated differentially by steroids. We analyzed by magnetic resonance imaging the effect of testosterone on the volume of RA and area X and on the dynamics of Mn(2+) accumulation in RA and area X of female starlings that had been injected with MnCl(2) through a permanent cannula implanted in HVC. Repeated visualization 6 weeks apart (before and after testosterone treatment) identified a volume increase of both nuclei in testosterone-treated birds associated with a concomitant decrease in controls. Following testosterone treatment, the total amount of Mn(2+) transported to RA and area X increased but the dynamics of accumulation, reflecting in part the activity of HVC neurons, was specifically altered in area X but not in RA. These data indicate that testosterone differentially affects the RA- and area X-projecting neurons in HVC. Manganese-enhanced magnetic resonance imaging (ME-MRI) thus provides repeated measures of connected brain areas and demonstrates testosterone-dependent regionally specific changes in brain activity and functional connectivity. The slow time scales investigated by this technique (compared to functional MRI) appear ideally suited for characterizing slow processes such as those involved in brain plasticity and learning.     

Implicit versus explicit measures of self-concept of self-control and their differential predictive power for spontaneous trait-relevant behaviors

Background and objectives

Low trait self-control constitutes a core criterion in various psychiatric disorders. Personality traits such as low self-control are mostly indexed by self-report measures. However, several theorists emphasized the importance of differentiating between explicit and implicit indices of personality traits, Therefore, the present study examined the unique predictive validity of an implicit measure of trait self-control for spontaneous dysfunctional behavior.

Methods

As a measure of implicit trait self-control, we used an irrelevant feature task: a speeded reaction time task comprising a task-relevant stimulus feature (i.e., capital vs. lower case letter type) and a task-irrelevant feature (high vs. low self-control word type). The irrelevant feature had to be ignored, while participants (n = 34) responded to the relevant stimulus feature. However, their response was either congruent or incongruent with the irrelevant stimulus feature, resulting in facilitated or deteriorated task performance. As indicators of trait-related spontaneous dysfunctional behavior, we included indices of frustration tolerance and the preference for short-term reward over meeting long-term goals. We also included two explicit measures of trait self-control: a self-report questionnaire and an explicit self-relevance rating of the implicit task stimuli.

Results

Specifically the implicit measure of trait self-control showed predictive validity for the target self-control behaviors.

Limitations

The predictive validity of implicit measures of personality traits requires further study in larger, non-student samples.

Conclusions

As predicted, the implicit measure of trait self-control showed superior predictive power for spontaneous trait-related behavior. This finding points to the relevance of complementing the routinely used self-report measures with implicit measures of trait self-control.     

Multiple Group Confirmatory Factor Analysis of the Young Schema-Questionnaire in a Dutch Clinical versus Non-clinical Population

So far, results on the dimensionality of the Young Schema-Questionnaire (YSQ) were based on exploratory factor analysis. In this study, confirmatory techniques were used to investigate the latent structure of the YSQ and its measurement invariance across a Dutch clinical (n = 172) and non-clinical (n = 162) sample. Data support the 16 factor structure as originally hypothesized by Young (Young, J. E. (1994). Cognitive therapy for personality disorders: A schema-focused approach (Rev. ed.). Sarasota, FL: Professional Resource Press), including Social Undesirability, which did not appear as a separate factor in earlier studies. Furthermore, results suggest factorial similarity across both samples. Best fit was found for a model in which inter-factor correlations and factor loadings were specified as invariant across samples while error variances were allowed to vary. An additional finding was that the YSQ can be split into two parallel parts. Parallel tests represent the same underlying constructs, and share identical psychometric properties, but contain different items. Their utilization could be highly profitable for research and clinical practice.

Airbag-induced thumb avulsion: two case reports

Although airbags are designed to save lives and protect victims from serious injuries, airbag deployment can cause unwanted lesions. In this case report, two cases are presented of young women who sustained an important fracture dislocation of the first carpometacarpal joint (CMC I joint) caused by airbag deployment during a car collision.     

One-stop routing for surgical interventions: a cost-analysis of endoscopic groin repair

Surgical Endoscopy - Single-visit (SV) totally extraperitoneal (TEP) inguinal hernia repair is an efficient service without impairment of safety or complication rate. Data on the economic impact of...     

Plasma proprotein convertase subtilisin kexin type 9 is a heritable trait of familial combined hyperlipidaemia

The aim of the present study was to investigate the relationship between circulating PCSK9 (proprotein convertase subtilisin kexin type?9) and FCHL (familial combined hyperlipidaemia) and, when positive, to determine the strength of its heritability. Plasma PCSK9 levels were measured in FCHL patients (n=45), NL (normolipidaemic) relatives (n=139) and their spouses (n=72). In addition, 11 FCHL patients were treated with atorvastatin to study the response in PCSK9 levels. PCSK9 levels were higher in FCHL patients compared with NL relatives and spouses: 96.1 compared with 78.7 and 82.0?ng/ml (P=0.004 and P=0.002 respectively). PCSK9 was significantly associated with both TAG (triacylglycerol) and apolipoprotein B levels (P<0.001). The latter relationship was accounted for by LDL (low-density lipoprotein)-apolipoprotein B (r=0.31, P=0.02), not by VLDL (very-low-density lipoprotein)-apolipoprotein B (r=0.09, P=0.49) in a subgroup of subjects (n=59). Heritability calculations for PCSK9 using SOLAR and FCOR software yielded estimates of 67-84% respectively (P<0.0001). PCSK9 increased from 122 to 150?ng/ml in 11 FCHL patients treated with atorvastatin (40?mg) once daily for 8?weeks (P=0.018). In conclusion, plasma PCSK9 is a heritable trait associated with both FCHL diagnostic hallmarks. These results, combined with the significant rise in PCSK9 levels after statin therapy, warrant further studies in order to unravel the exact role of PCSK9 in the pathogenesis and treatment of this highly prevalent genetic dyslipidaemia.